Devices & Technology

Public Health’s Take on Technology

November 18, 2011 - While much of the focus on health care information technology (HIT) is in hospitals and health systems, the public health arena is also impacted by innovations that help improve care. From electronic medical records (EMRs) and telehealth to mobile technologies and interoperable data systems, HIT plays an important role in public health care in communities across the country.

According to Jim Kirkwood, MPH, senior director of e-health at the Association of State and Territorial Health Officials (ASTHO), a national nonprofit organization that represents public health agencies in the United States, the EMR--also known as the electronic health record (EHR)--is just as important in the public health arena as it is in hospital settings.

“Getting data from the EMR will be very important to public health in the future, and that’s becoming apparent now,” Kirkwood said. “Hospitals and doctors’ offices are implementing them and they need to get their data to public health agencies.

“The best example is with immunizations, where data collection is an important component of maintaining interoperability,” he explained. “As interoperability develops over time, it will be a two-way connection, with immunization data going from the immunization record to the EMR.”

Kirkwood added that electronic lab reporting is another area that corresponds with the EMR, with more than half of the 50 states already utilizing a system that tracks lab data for communicable diseases.

Improving access through telehealth

Access to care in rural communities is always a concern of public health agencies. Recognizing that the disparities are great in areas that are a distance from major health care providers, states are utilizing telehealth technologies to improve care coordination and disease consulting, and provide health education to both patients and providers.

One such example is New Mexico’s Project ECHO (Extension for Community Outcomes), which helps to treat and prevent chronic disease in rural and underserved parts of the state through the use of videoconferencing technology. The innovative public health program was created by UNM liver specialist Sanjeev Arora, M.D., who was disheartened by the number of patients who came to him with late-stage hepatitis because they had to travel too far from their rural home to the university in Albuquerque to receive treatment.

With the idea that he could mentor rural physicians through teleconferencing to increase their ability to provide specialized care, he established Project ECHO’s mission “to develop the capacity to safely and effectively treat chronic, common, and complex diseases in rural and underserved areas, and to monitor outcomes of this treatment.”

Through TeleECHO Clinics, medical experts at the University of New Mexico (UNM) are connected with primary care physicians and other clinicians in rural areas to develop treatment plans for patients with a wide variety of conditions, from asthma and pulmonary care to heart failure, HIV and hepatitis.

Sharing data in the clouds

Cloud technology is the latest buzz term making headlines in many industries, including health care. Rather than storing data in in-house servers, organizations are utilizing a central cloud system to collect and share medical information.

One such project is the BioSense Program Redesign, a joint program between the Centers for Disease Control and Prevention and several other public health agencies, including ASTHO.

According to the program website, the focus of the technological redesign is to: “Improve coordination and links between existing state and local disease surveillance monitoring systems and BioSense” and “build health monitoring infrastructure and human capacity where needed to ensure rapid and enhanced interchange of timely information.”

Kirkwood explained, “It’s an innovative program to promote data sharing for trends in disease syndromes and situation awareness.”

With key public health agencies sharing data, the cloud technology integrates state and local information in a way that allows for timely reporting and monitoring of major health threats.

Technology’s impact on public health nursing

Finally, while these technologies improve public health on a global scale, public health nurses are able to be on the front lines utilizing technology to improve health and data collection in their communities.

“Community nurses are immunizing people through clinics and then entering data into an immunization registry. They’re conducting well-baby visits to mother and child and inputting data into a record that allows them to see the whole picture. They’re interviewing patients and looking at data flows on communicable diseases,” Kirkwood concludes. “In the future, these community nurses will be able to look at the whole person within the EMR. This will all become more and more important as they’re able to get that information back to the provider and get patients into public health programs that can provide the intervention they need.”